Vaccination against Hepatitis B Virus (HBV) became mandatory in Italy for all newborns and twelve years-old individuals in the 1991. The immunogenicity of HBV vaccine and the effectiveness of the universal immunization strategy have been widely demonstrated. However the need to assess the antibody concentrations above the well known serological correlate of protection for HBV infection (≥ 10 mIU/mL), established in individuals immunized with a three doses vaccination course, is still recommended in subjects exposed to occupational risks in different settings, particularly the healthcare services...

Objective: to reflect on nursing care and its epistemology from its historical, theoretical, philosophical, spiritual dimensions and as a social practice. Method: discussions originated in the discipline "Epistemology of caring", from the graduate nursing program of the School of Nursing, Federal University of Minas Gerais, and in critical analysis of nursing literature together with the professional practice of the authors. Results: we identified the necessity of developing a critical conscience on health care provision, research, and teaching, as well as on challenges in maintaining high standards of working interpersonal relationships, which has a profound impact on population health...

BACKGROUND: Persistent Organic Pollutants (POPs) are well-known environmental contaminants which are associated with chronic diseases. As foods are the major sources of human exposure to toxic pollutants, we developed an integrated dietary and education program to eliminate the chemical toxin throughout the human body. The present study evaluated effects of the dietary detoxification program on serum γ-glutamyltransferase (GGT), anthropometric data and metabolic biomarkers in adults...

As advances in Critical Care Medicine continue, critically ill patients are surviving despite the severity of their illness. The incidence of acute kidney injury (AKI) has increased, and its impact on clinical outcomes as well as medical expenditures has been established. The role, indications and technological advancements of renal replacement therapy (RRT) have evolved, allowing more effective therapies with less complications. With these changes, Critical Care Nephrology has become an established specialty, and ongoing collaborations between critical care physicians and nephrologist have improved education of multi-disciplinary team members and patient care in the ICU...

Importance: Concerns exist about the current quality of undergraduate medical education and its effect on students' well-being. Objective: To identify best practices for undergraduate medical education learning environment interventions that are associated with improved emotional well-being of students. Data Sources: Learning environment interventions were identified by searching the biomedical electronic databases Ovid MEDLINE, EMBASE, the Cochrane Library, and ERIC from database inception dates to October 2016...

BACKGROUND: Of the 1.4 million Americans who sustain traumatic brain injuries (TBIs) each year up to half experience substance use disorders (SUDs). This often leads to various issues such as increased rates of mental health problems and delay or lack of return to full employment. AIMS: The purpose of this program evaluation was to describe Vinland National Center's (Vinland's) client and staff perceptions of a 4-week mindfulness-based intervention adapted from the original mindfulness-based stress reduction program for persons experiencing SUDs and TBIs...

PROBLEM: Significant off-campus domestic study away experiences have been shown to be a transformative active learning environment for students and achieve similar learning outcomes as study abroad programs. METHODS: This manuscript describes the conception, development, and pedagogical approach of a faculty-led domestic study away experience in New York City for pre-licensure and post-licensure nursing students as an active learning strategy for developing cultural competence...

We present an updated cost analysis to provide new estimates of the cost of providing community-based treatment for severe acute malnutrition, including expenditure shares for major cost categories. We calculated total and per child costs from a provider perspective. We categorized costs into three main activities (outpatient treatment, inpatient treatment, and management/administration) and four cost categories within each activity (personnel; therapeutic food; medical supplies; and infrastructure and logistical support)...

Childhood obesity is a complex, worldwide problem. Significant resources are invested in its prevention, and high-quality evaluations of these efforts are important. Conducting trials in school settings is complicated, making process evaluations useful for explaining results. Intervention fidelity has been demonstrated to influence outcomes, but others have suggested that other aspects of implementation, including participant responsiveness, should be examined more systematically. During Food, Health & Choices (FHC), a school-based childhood obesity prevention trial designed to test a curriculum and wellness policy taught by trained FHC instructors to fifth grade students in 20 schools during 2012-2013, we assessed relationships among facilitator behaviors (i...

BACKGROUND: The increasing prevalence of chronic diseases requires changes in health care delivery. In COPD, telemedicine appears to be a useful tool. Our objective was to evaluate the efficacy (in improving health care-resource use and clinical outcomes) of a telemonitoring-based program (telEPOC) in COPD patients with frequent hospitalizations. MATERIALS AND METHODS: We conducted a nonrandomized observational study in an intervention cohort of 119 patients (Galdakao-Usansolo Hospital) and a control cohort of 78 patients (Cruces Hospital), followed up for 2 years (ClinicalTrials...

PURPOSE: The purpose of the study was to explore the relationship between leadership support for health promotion and job stress, wellness program participation, and health behaviors. DESIGN: A cross-sectional survey design was used. SETTING: Four worksites with a range of wellness programs were selected for this study. PARTICIPANTS: Participants in this study were employees (n = 618) at 4 organizations (bank, private university, wholesale supplier, and public university) in the southeastern United States, each offering an employee wellness program...

BACKGROUND: Self-management can optimize health outcomes for individuals with chronic pain (CP), an increasing fiscal and social burden in Canada. However, self-management is rarely integrated into the regular care (team activities and medical treatment) patients receive. Health information technology offers an opportunity to provide regular monitoring and exchange of information between patient and care team. OBJECTIVE: To identify information needs and gaps in chronic pain management as well as technology features to inform the development of an Internet-based self-management program...

BACKGROUND: The objective of this study was to identify the epidemiological and clinical characteristics of heart failure (HF) patients in Greece as well as the economic burden and the distribution of costs for the management of the disease. METHODS: Eight Greek secondary and tertiary cardiology centres from different cities have participated in a prospective, observational survey, the ESC HF Pilot Survey. 307 patients with HF, 177 hospitalised and 130 outpatients, have been recruited and monitored for 12months...

Objective The aim of the present study was to identify factors affecting the job satisfaction and subsequent retention of Aboriginal mental health workers (AMHWs).Methods Five AMHWs working in New South Wales (NSW) for NSW Health in rural and remote community mental health (CMH) services participated in in-depth, semi-structured interviews to understand how employment and rural living factors affected workers' decisions to stay or leave their CMH positions.Results Using a constructivist grounded theory analysis, three aspects negatively impacting the job satisfaction of AMHWs were identified: (1) difficulties being accepted into the team and organisation; (2) culturally specific work challenges; and (3) professional differences and inequality...

The aim of this study, carried out before the beginning of human papillomavirus (HPV) vaccinations as a National Immunization Program (NIP) in Korea in 2016, is to assess the ranges of perceptions and personal experience and their influences on attitudes regarding HPV vaccinations of children, among mothers of adolescent (9-14 years of age) daughters in Korea. From November 2015 to February 2016, we distributed a written questionnaire to mothers who had daughters aged 9-14 years. The questionnaire consisted of several questions, related to knowledge of HPV, personal experiences of HPV vaccination, and attitudes toward HPV vaccinations of their adolescent daughters...

Minimal contact lifestyle interventions with multiple components coupled with health screening have the potential to improve worker health. The purpose of this study was to test a minimal contact multiple component lifestyle diet and exercise intervention. The multiple components that were included in this project included a worksite health screening, brief counseling session, emailed newsletter, and a pedometer. In response to the intervention, participants reported an increase in green salad, fruit, and vegetable consumption as well as an increase in self-efficacy for consuming three servings of fruits and vegetables a day...

BACKGROUND: China is facing the challenges of an expanding ageing population and the impact of rapid urbanization, cancer rates are subsequently increasing. This study focuses on the changes of the ageing population and projects the incidence of common ageing-related cancers in the urban regions in China up to 2030. SOURCES OF DATA: Cancer incidence data and population statistics in China were extracted from the International Agency for Research on Cancer. AREAS OF AGREEMENT: Due to improving longevity in China, continuous and remarkable increasing trends for the lung, colorectal and prostate cancers are expected...

Recovery-oriented practices that promote client-centered care, collaboration, and functional outcome have been recommended to improve treatment engagement, especially for individuals with serious mental illness (SMI). Psychological well-being (PWB) is related to recovery and refers to experiencing purpose and meaning in life through realizing one's potential. The recently completed Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP) study sought to improve quality of life, functional outcome, and well-being in individuals with first episode psychosis (FEP)...

The relevance of cancer rehabilitation as a public health issue grows steadily as cancer incidence, survival, and mean patient age increase. Reported rates of physical impairment and disability are already high, prior to the anticipated influx of aged cancer survivors. Despite the high prevalence of cancer-related disablement, treatment rates, even for readily remediable physical impairments, are as low as 1-2%. In addition to low referral rates, a challenge to patient-centric cancer rehabilitation is a fractured system that requires multiple visits to a range of specialists to address even a single issue, and cancer survivors generally have several...

BACKGROUND: Economic evaluation has been implemented to inform policy in many areas, including coverage decisions, technology pricing, and the development of clinical practice guidelines. However, there are barriers to evidence-based policy in low- and middle-income countries (LMICs) that include limited stakeholder awareness, resources and data availability, as well as the lack of capacity to conduct country-specific economic evaluations. This study aims to survey health policy experts' opinions on barriers to use of cost-effectiveness data in these settings and to obtain their advice on how to make a new cost-per-DALY database being developed by Tufts Medical Center more relevant to LMICs...